Provider Demographics
NPI:1669687141
Name:PEREZ, RENE (MD)
Entity Type:Individual
Prefix:DR
First Name:RENE
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11212 ST. HWY 151, #350
Mailing Address - Street 2:PLAZA 2
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251
Mailing Address - Country:US
Mailing Address - Phone:210-281-5066
Mailing Address - Fax:210-281-4459
Practice Address - Street 1:11212 ST HWY 151 #350
Practice Address - Street 2:PLAZA 2
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251
Practice Address - Country:US
Practice Address - Phone:210-281-5066
Practice Address - Fax:210-281-4459
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6336207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AW080OtherBCBS ID
TX1945966-04Medicaid
TX450576052OtherTAX ID
TX8K9676Medicare PIN